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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Mental health and insomnia problems in healthcare workers after the COVID-19 pandemic: A multicenter cross-sectional study
Wei Ding, Min-Zhong Wang, Xian-Wei Zeng, Zhen-Hua Liu, Yao Meng, Hui-Ting Hu, Yuan Zhang, Yu-Guang Guan, Fan-Gang Meng, Jian-Guo Zhang, Shu Wang
Wei Ding, Department of Public Health, Liaocheng People’s Hospital, Liaocheng 252000, Shandong Province, China
Min-Zhong Wang, Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
Xian-Wei Zeng, Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Zhen-Hua Liu, Sleep Medicine Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
Yao Meng, Department of Neurology, The First Affiliated Hospital of Shandong First Medical University, Jinan 250014, Shandong Province, China
Hui-Ting Hu, Department of Neurology, Heze Mudan People’s Hospital, Heze 274000, Shandong Province, China
Yuan Zhang, Neonatal Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
Yu-Guang Guan, Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
Fan-Gang Meng, Jian-Guo Zhang, Shu Wang, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Co-corresponding authors: Shu Wang and Min-Zhong Wang.
Author contributions: Ding W collected the data, analyzed the data, and revised the manuscript; Wang MZ designed the study, collected the data, analyzed the data, and revised the manuscript; Zeng XW, Liu ZH, Meng Y, Hu HT, Zhang Y, Guan YG, Meng FG, and Zhang JG collected the data, analyzed the data, and revised the manuscript; Wang S designed the study, collected and analyzed the data, drafted the manuscript, and revised the manuscript; All the authors read and approved the final manuscript. Wang S and Wang MZ contributed equally to this work as co–corresponding authors. Both Wang S and Wang MZ have played important and indispensable roles in the study design, data collection, data interpretation, and manuscript preparation as the co-corresponding authors. Wang S conceptualized, designed, and analzed data for this study. He searched the literature, revised and finished the early version of the manuscript with the focus on mental health and insomnia problems in healthcare workers. Wang MZ was instrumental and responsible for data re-analysis and re-interpretation, comprehensive literature search, preparation and submission of the current version of the manuscript with a new focus on analyzing influencing factors of mental health and insomnia problems. He also supervised the whole process of the project. This collaboration between Wang S and Wang MZ is crucial for the publication of this manuscript and other manuscripts still in preparation.
Institutional review board statement: This study was reviewed and approved by the Liaocheng People’s Hospital (Shandong) ethics committee (No. 2023226).
Informed consent statement: Prior to enrollment, informed consent was provided by all participants by online clicking of the “agree to the consent” button on the guiding page of the electronic questionnaire.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement checklist of items, and the manuscript was prepared and revised according to the STROBE Statement checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Shu Wang, MD, Neurosurgeon, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 South Fourth Ring West Road, Beijing 100070, China. wangshu.cn@outlook.com
Received: January 14, 2024
Revised: March 19, 2024
Accepted: April 25, 2024
Published online: May 19, 2024
Processing time: 123 Days and 3.8 Hours
BACKGROUND
Healthcare workers (HCWs) are at increased risk of contracting coronavirus disease 2019 (COVID-19) as well as worsening mental health problems and insomnia. These problems can persist for a long period, even after the pandemic. However, less is known about this topic.
AIM
To analyze mental health, insomnia problems, and their influencing factors in HCWs after the COVID-19 pandemic.
METHODS
This multicenter cross-sectional, hospital-based study was conducted from June 1, 2023 to June 30, 2023, which was a half-year after the end of the COVID-19 emergency. Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs. Symptoms such as anxiety, depression, and insomnia were evaluated by the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Insomnia Severity Index. Factors influencing the symptoms were identified by multivariable logistic regression.
RESULTS
A total of 2000 participants were invited, for a response rate of 70.6%. A total of 1412 HCWs [618 (43.8%) doctors, 583 (41.3%) nurses and 211 (14.9%) nonfrontline], 254 (18.0%), 231 (16.4%), and 289 (20.5%) had symptoms of anxiety, depression, and insomnia, respectively; severe symptoms were found in 58 (4.1%), 49 (3.5%), and 111 (7.9%) of the participants. Nurses, female sex, and hospitalization for COVID-19 were risk factors for anxiety, depression, and insomnia symptoms; moreover, death from family or friends was a risk factor for insomnia symptoms. During the COVID-19 outbreak, most [1086 (76.9%)] of the participating HCWs received psychological interventions, while nearly all [994 (70.4%)] of them had received public psychological education. Only 102 (7.2%) of the HCWs received individual counseling from COVID-19.
CONCLUSION
Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic, they still faced challenges and greater risks than did the general population. Identifying risk factors would help in providing targeted interventions. In addition, although a major proportion of HCWs have received public psychological education, individual interventions are still insufficient.
Core Tip: Limited information is known about mental health and insomnia problems among healthcare workers after the coronavirus disease 2019 (COVID-19) pandemic. This multicenter cross-sectional study revealed that 16.4%-20.5% (289) of healthcare workers overall had anxiety, depression, or insomnia symptoms; identified that those who were nurses, were female, had been hospitalized for COVID-19, or died in families or friends were at high risk of symptoms. Although a major proportion of healthcare workers have received public psychological education, individual interventions are still not sufficient.
